Doctor Helps Kids Deal With Diabetes

Ask just about any of Dr. Francine Kaufman’s pediatric patients about her and the superlatives will start to fly.

“Fran is one of the busiest people I know … yet she’s still able to find time for me and make me feel like the only child in the hospital,” said 15-year-old Katie Zucker.

Chris Paonessa, 14, calls Kaufman his “mentor and role model.”

“She’s not just my doctor, she’s my friend,” noted college student Lupe Pena, a patient of Kaufman’s for 15 years.

The compliments come despite the fact that Kaufman, a pediatric endocrinologist and the head of the Center for Diabetes, Endocrinology and Metabolism at Childrens Hospital Los Angeles, is often the person who delivers the devastating news to children that they have diabetes. It is Kaufman who orchestrates their transition from having a carefree childhood to one dramatically altered by the constant need to monitor diet, measure blood sugar and administer insulin.

If there’s such thing as a typical doctor, Kaufman surely doesn’t fit the mold. First, as Zucker noted, “She’s the only doctor we know who comes to work in stilettos and a miniskirt.”

While doctors are cautioned not to get too involved with their patients, Kaufman has invited several of them to stay at her home for periods ranging from days to years. One became a member of the family, whom Kaufman refers to as her “near son.” Another currently lives with the Kaufmans during the week while attending college.

Kaufman’s quest to eradicate diabetes extends beyond her direct work with pediatric patients. Among other things, she is a professor of pediatrics at the Keck School of Medicine at USC, the president of the American Diabetes Association (ADA) and lead researcher on two National Institutes of Health (NIH) diabetes studies. That’s in addition to being the wife of a Cedars-Sinai pediatrician and mother of two grown sons.

Kaufman was honored by the ADA as their 2003 Woman of Valor at a tribute dinner on Feb. 6. Along with physicians nationwide, she is alarmed at the increasing number of children diagnosed with Type 2 diabetes, which used to be known as adult-onset diabetes.

“Twenty-five percent of new onset diabetes in children is Type 2,” Kaufman noted.

This increase is tied to the rise in childhood obesity, now considered an epidemic, and Kaufman is concerned about the poor eating habits and lack of physical exercise among school-age children.

“We’re seeing too many kids who are gaining too much weight,” she said.

To address this problem, Kaufman chaired the Los Angeles County Task Force on Children and Youth Physical Fitness, which recommended policies to support physical activity and healthy eating among children. She was one of the driving forces behind the Los Angeles Unified School District’s policy to prohibit soft-drink sales at middle and high schools starting January of next year (they are already banned in elementary schools).

At Childrens Hospital Los Angeles, her team is involved in NIH multicenter studies to see how lifestyle modifications can impact children with Type 2 diabetes, and whether diabetes can be prevented in the relatives of those with the disease.

She has collaborated on diabetes initiatives with Secretary of Health and Human Services Tommy G. Thompson, who flew in from Washington, D.C., to present Kaufman’s Woman of Valor Award. Saluting her work nationally and in such locations as Israel, Ecuador and Mongolia, Thompson said Kaufman has “the courage and the drive to make a difference in the lives of millions, not just here but around the world.”

When Kaufman sees a need, she fills it. One of the biggest challenges for diabetics is keeping the level of their blood sugar stable, especially at night. Kaufman came up with the idea of using uncooked cornstarch to formulate a patented food bar that reduces the incidence of hypoglycemia by promoting gradual and consistent absorption of glucose. For some patients, it has eliminated the need to wake up during the night to snack or test their blood sugar.

To help children understand the nature of diabetes, Kaufman helped develop a CD-ROM game called Life Adventure Series. And when she noticed that patients were having difficulty calculating the dosage of insulin they needed, she designed a simple slide card that matches blood sugar numbers and corresponding insulin dosages.

With all her roles and accomplishments, Kaufman’s direct impact on her patients is perhaps the most dramatic.

As Paonessa, who has successfully completed a marathon said, “She made me believe that everything is possible, even with diabetes.”

The Life Adventure Series: Diabetes CD-ROM is available
free of charge to children with diabetes and their parents. For information,
visit www.starbright.org/projects/diabetes/order.html